In all fairness, this wasn't these folks' first rodeo, so to speak. These were seasoned nurses and birth attendants who help women deliver babies all the time. However......the HBB program was a different approach for them. Often, in Rwanda, if a baby is born not breathing, the baby is set aside and the birth attendant tends to the mother. After all, there is the placenta to be delivered, etc. With the information and training they received over the past two days, these people realized that they might save more babies' lives if they simply spent that one minute assisting them to breathe and drying and stimulating them and keeping them warm. Simple, yes? But life changing for those babies who otherwise would be set aside to fend for themselves, to live or die by chance. These people realized that they have the power and the skills to make a difference in the lives of those babies......and that, my friends, is HUGE! It has been my experience over the course of my career that if you want to make a change in practice, you have to first make a change in the mindset of the people whose practice you want to change. Just telling them that this is the way things are going to be done now is not enough. After lunch we spent time with our learners while we waited for Dr. Emmanuel to come speak with us. We asked them questions and they asked us questions, and over those few minutes we created quite a debate among them. Many were saying that placing the infant on the mother's abdomen after birth was a change they just didn't see a reason for. There was a lot of arguing (well, it sounded like arguing, but was in Kinyarwandan so who knows?) Once Yvan translated for us, he told us that they had been arguing about the whole process of HBB because they often found themselves to be the only birth attendant with two or even three mothers delivering at the same time. How were they supposed to be three places at once?!? How indeed. They then talked about the Golden Minute and how that they probably, even with multiple deliveries, could spend just one minute with that baby. And if the baby started crying while still on the momma's abdomen, then they could wrap it and leave it with the mom while they attended to the other delivering mommas. And that would free up their only warmer for babies who needed advanced care. It was that simple in their minds.....it made sense to them because it was practical, and because, if the baby didn't need advanced care, it allowed them to use the baby's own mother as an attendant. Who better to ensure the well-being of their baby than the momma? They said this would change their practice. So....they went from "this isn't how we've always done it" (how many times have I heard that before--everywhere I've ever worked, and probably said it a few times myself!) to "this will change our practice." And why? Because it was explained in a way that made sense, and because they were given the evidence supporting it. Simple.
When Dr. Emmanuel arrived we presented the certificates and then he spoke to the learners and to us. He told his staff how proud he was of them for taking this training and learning how to save more babies' lives as a result. He then told us how vital this training was to Rwanda, and to the survival of its children. What better validation could we have asked for?!?
And then, I presented him with two training kits so their new trainers could continue to train others in the district. This, as you can see, made him a very happy man indeed!
So, tomorrow I will leave Rwanda a very happy soul. I am so very proud of my colleagues who joined me. Thankful for their willingness to come and learn yet another program and then turn around and put it to immediate use, and also for their willingness to share their expertise with other nurses in this country. I think they found, as I have on many visits before, that we are really all quite similar in the areas that are important. We love our families, we love babies, and we love to laugh. And so we did......and we celebrated our similarities and sought to understand and accept our differences. It may not be world peace.....but it's a start!
No comments:
Post a Comment